In January, the International Center for Research on Women (ICRW) and the United Nations Foundation (UNF) hosted a discussion about milestones in adolescent and youth health and development. All of the presenters emphasized the need for a holistic approach to the health and development of young people—one that enables them to delay marriage and childbearing, access youth-friendly health services, prevent the onset of mental disorders and noncommunicable diseases, and thrive in a supportive environment. Amanda Keifer of the Public Health Institute highlighted that with the creation of the Bali Global Youth Forum Declaration, the global community is moving in the right direction by putting young people’s rights at the heart of development.
by Alexandra Hervish, policy analyst, International Programs
On October 11, we are celebrating the first International Day of the Girl—a movement to speak out against gender bias and advocate for girls’ rights across the globe. Given that there is already an International Women’s Day in March as well as many ongoing efforts to raise the visibility of global women’s issues, one might ask, is it necessary to devote an entire day to the girl child? The answer to that question is a resounding yes.
Although the global community recognizes that most women experience discrimination and inequality early in life, the International Day of the Girl provides an opportunity to examine the unique vulnerabilities girls face due their age as well as the lack of power over their lives. Considering that adolescent girls make up nearly 20 percent of the population in the developing world but are often excluded from civil society, livelihood opportunities, health care on the basis of gender and age, and investments in this group are critical to help nations achieve gender equality, break the cycle of poverty, and support sustainable development today and for future generations.
Last year the United Nations focused the world’s attention on the growing impact of noncommunicable diseases (NCDs) on low- and middle-income countries. In regions where infectious diseases are still common, diseases like diabetes, cardiovascular disease, chronic respiratory diseases, and cancer are rising at an alarming rate. These diseases will swamp health care systems; and increasing urbanization and development will only accelerate the strain. What can be done?
NCDs share four risk factors: tobacco use, excessive alcohol, poor diet (and obesity), and sedentary lifestyle.
I first became interested in family planning and reproductive health during a class on health and developing countries in college. It was fascinating to me to learn how access to reproductive health has far-reaching health, economic, and societal impacts. However, I didn’t start focusing on the particular reproductive health needs and rights of young people until I studied abroad in northern Nigeria. There, I met young women and men who had frighteningly incorrect information about sexuality, pregnancy, and HIV. In the market, I saw 12- and 13-year-old girls who were dressed to advertise their eligibility for marriage, and I was told they would begin childbearing within the next year or two. When I graduated from college and started in my position as a Policy Fellow in USAID’s Office of Population and Reproductive Health, I brought these lessons with me.
Demographics has played an important role in the Arab rebellions, said Joseph Chamie of the Center for Migration Studies during a recent panel discussion at the annual Population Association of America (PAA) meeting in San Francisco. But demographics can exacerbate other serious problems, including brutal repression, human rights violations, government corruption, poverty, unemployment, religious and tribal rivalries, and a large influx of migrants and refugees. The largest refugee population in the world is in the Arab region, he said. The panel’s speakers were John Casterline, Ohio State University; Richard Cincotta, the Stimson Center; Farzaneh “Nazy” Roudi, Population Reference Bureau; and Nasra Shah, Kuwait University.
In his presentation, “Potential Upheaval in the Arab Region—Impact on Reproductive Change?”, John Casterline focused on the consequences of the rebellions, while the following speakers outlined more of the determinants. Casterline illustrated his presentation with anecdotes from his visits to the region and conversations with people, concluding that while it’s still early, “a period of dashed hope seems to be settling in.” The rebellions seem to have brought a pronatalist movement into effect, with the rejections of a “Western agenda.” Demographic data and demographic analysis have lost legitimacy since the old regime, he said. The return of electoral politics has established a direct relationship between population and political weight. Still, he added, couples ultimately make their own decisions about their households.
A young Egyptian protester holding an Egyptian flag, Cairo, Egypt. Photo: Kim Eun Yeul / World Bank
Richard Cincotta discussed “Politicodemographic Forecasts of the Rite of Democracy in North Africa.” He presented a demographic model of the region and said that in his view, the era of democratization (in its third wave) is not over, yet.
Nazy Roudi, director of the Middle East and North Africa (MENA) Program at PRB, presented, “Numbers Don’t Lie: Youth in Egypt.” One in four Arabs is an Egyptian, she said, and unemployment among youth in the MENA region is the highest in the world—2.5 times higher than in East Asia and South Asia. And unemployment among women is far higher than among men. She cited the Survey of Youth in Egypt 2009 in which women said the reason they did not find a job was because they believed there was no job available for the qualifications they had. Meanwhile, men responded that they were unable to find a job because they did not think that an available job paid enough. Roudi echoed Casterline’s earlier point that while government policies are important, more important is the balance of gender roles within a family, and that women feel empowered to talk with their husbands about fertility decisions. “My prediction is that the TFR is going to become higher in Egypt,” Roudi said.
HIV/AIDS in Cameroon. The preliminary report of the 2011 Cameroon Demographic and Health Survey/HIV (DHS/HIV) has been released (in French). This survey tested 13,503 women and men ages 15-49 and 699 men ages 50-59 for HIV infection. The results indicate that 4.3 percent of the 15-49 age group were HIV positive, 5.6 percent among females and 2.9 percent among males. The males ages 50-59 were 2.9 percent positive. The 2011 prevalence was lower than that reported in the 2004 Cameroon DHS, which was 5.5 percent for 15-49 year-olds, 6.8 percent among females and 4.1 percent among males.
Youth Tax in Germany. Germany is likely to impose a 1 percent additional income tax on workers over the age of 25 as a “demographic reserve” to prepare for the time when German baby boomers of the 1950s and 1960s will swell the ranks of pensioners. Official projections show that there will be 7 million fewer workers by 2025 to support retirees. Germany’s total fertility rate fell below the replacement level over 40 years ago and is currently about 1.35 children per woman.
Latest Data on the Sex Ratio at Birth (SRB) in India. Following up on an earlier blog post on this subject, progress on this measure has clearly stalled for a number of years. The national campaign against the abortion of female fetuses may be in for a difficult stretch. The graphs below update the Sample Registration System data to the period 2008-2010. Since there about 5 percent more male births than female births worldwide, a normal sex ratio at birth in India would be 950 female births per 1,000 male births. India’s SRB is the reverse of most other countries which typically show male births per 100 female births. Note particularly the two states with the lowest SRB, Punjab and Haryana. Improvement in their SRBs stopped three or four years ago. A somewhat similar trend can be seen in the five states in the second graph although their ratios are better. The national SRB in India is 905, 898 in urban areas and 907 in rural. More data from the new report will be in the next blog post.
One area that has seen tremendous growth is Nairobi’s largest slum, Kibera. While experts have given estimates ranging from 270,000 to 2 million residents, Kibera is a large area of informal settlements plagued by challenges such as the lack of electricity, job opportunities, and high levels of violence.
While it may be easier to focus on what is lacking in Kibera, there are also many services being provided in the community including affordable and quality reproductive health care by organizations such as Marie Stopes Kenya.
Marie Stopes Kenya was established in Kenya in 1985 as a locally registered nongovernmental organization. It is Kenya’s largest and most specialized sexual reproductive health and family planning organization and is known for providing a wide range of high-quality, affordable, and client-centered services to men, women, and youth throughout Kenya. In 1997, Marie Stopes Kenya opened its first clinic in Kibera and began offering reproductive health services at an affordable rate for residents.
During a visit to the clinic, I had the honor of interviewing the Kibera Clinic Manager, Pamela Warinda. Pamela is a nurse and midwife by training and has been working with Marie Stopes since 1995. She began managing the clinic in Kibera in September, 2010.
by Mia Foreman, policy analyst, International Programs
Kibera, located 5 km from the city center of Nairobi, has been called Africa’s second-largest slum with estimates of around 200,000 to 270,000 residents. Kibera has many challenges, including lack of employment, electricity, proper sanitation, and housing, and high rates of drug use and violence — especially rape. The lack of employment and education are among the biggest contributing factors to the cycle of poverty with many young people surviving through illegal activities, such as prostitution or drug dealing.
Although there are many hardships, every day local citizens are making a difference in this community. I was fortunate enough to spend time with two young ladies, ages 20 and 22, who are doing just that as members of the community-based organization Kibera Hamlet.
Kibera Hamlet was founded in 2004 by youth in Kibera and currently serves more than 150 adolescents and children from the area, 65 percent of whom are orphans and 10 percent of whom are HIV positive. The organization is involved in many activities including The Girls Empowerment Project. The overall goal of the project is to empower young girls to change their lives and decide for themselves what they want their future to look like.
The Girls Empowerment Project was created to bring together young girls to discuss the daily challenges of living in Kibera, such as early marriage, unsafe abortion, pregnancy, and female genital mutilation. The average situation for a girl growing up in Kibera is quite dire. If she is still single at a young age, chances are her family will send her out to look for money to help with the cost of living. Most of the time, this means prostitution. A girl will sleep with a man for 50 Kenya shillings (KSH), less than one U.S. dollar. This is not enough to put food on the table so she will need to sleep with four to five men a day to make enough money to bring back to her family. If she asks the man to use a condom, the price goes down so most girls don’t use condoms.
by Mark Mather, associate vice president, Domestic Programs
In the U.K., they are called NEETS, people who are “Not in Employment, Education, or Training.” In Spain and Mexico, they have been called Generation Neither-Nor. We have them in the United States too, and their numbers have increased since the onset of the recession—especially among men. A new report by PRB shows that the percent of young men ages 25 to 34 who are neither working nor attending school increased sharply between 2007 and 2010, from 14 percent to 19 percent. During the same period, the share of women who were not working and not in school remained steady at 26 percent. Part of this gender difference can be explained by women’s earlier age at marriage, compared with men.
Percent Distribution of Young Adults Ages 25-34 by School Enrollment and Employment
Status, 2007 and 2010
School Enrollment, Employment Status
In school, working
In school, not working
Not in school, working
Not in school, not working
Source: U.S. Census Bureau, American Community Survey.
by Jay Gribble, vice president, International Programs
The ICFP 2011 High-Level Meeting organized for Ministers of Planning, Finance, and Health of African countries is focusing on achieving the demographic dividend. While it’s easy to talk about this process that led to the economic success of the “Asian Tigers” in abstract terms, it’s more difficult to speak in specifics about it. Fortunately, Ruth Levine of the Hewlett Foundation did focus her comments on the need to pay attention to the needs of youth—highlighting the “Millennium Development Babies” –the cohort born in 2000 which will soon be reaching age 12. As the largest birth cohort in human history, the outcome of this generation can either energize or destabilize societies around the world. I’d like to reflect on a few of Ruth’s comments.
While half of the world’s population is under age 25, the median ages in African countries range from 14 to 20 years of age. Imagine living in a country where half of the population is age 14 or younger! So what is life like for these young people? Although countries are successfully increasing educational enrollment, one also has to look at quality: In 14 countries, less than 1 in 5 girls who finished primary school can read a simple sentence. And 1 in 3 women ages 20 to 24 were married before age 18—they were child brides, and quickly become young mothers, posing risks to health and limiting economic opportunities. As more young people live in cities and urban areas, what opportunities do they have for an economically secure future?